How COVID-19 affects our hormones, what science tells us so far
INDIANAPOLIS (WISH) — The coronavirus is complicated. We’ve known this since the very beginning when the first case landed in the U.S. back in January. New discoveries occurred every day, and they still are.
Inflammation associated with the coronavirus is one of the most dangerous complications and now scientists are beginning to understand a new, equally dangerous complication: the possibility of COVID-19-induced hormonal dysfunction.
Hormones are part of the endocrine system — one of the 12 physiological systems of the body — and is made up of a series of glands that produce hormones responsible for metabolism, tissue growth and development, and reproduction, to name a few. These glands signal the release of hormones when our body needs them to perform a specific function.
Needless to say, if the endocrine system isn’t working, our bodies are in trouble.
In a recent paper published in the Journal of Endocrinology Investigation, authors discuss the relationship between five types of endocrine glands that may be affected by the coronavirus.
News 8 spoke with Dr. Melissa Cavaghan, endocrinologist at Indiana University School of Medicine, to talk about the paper, possible reasons why certain parts of the endocrine system may be targeted, particularly the pancreas, reproductive hormones, the adrenal glands, the hypothalamus-pituitary and thyroid. She also explained the role they play in the body as well as the potential side effects if disrupted.
Why would COVID-19 attack the endocrine system? How does this happen?
“COVID-19 will enter any tissue that expresses a particular type of receptor called the ACE2 receptor,” Cavaghan said.
We have those particular types of receptors in most, if not all, of our endocrine tissues. Those receptors are exposed in the pancreas, testes and possibly in the pituitary gland. This is probably the mechanism.
This ACE2 receptor is also found in the lungs — coined as the “coronavirus entry port” — as well as the heart and blood vessels.
What does the pancreas do? And what are the potential COVID-19 side effects should I get infected?
“Most of the pancreas creates digestive enzymes, but the 1% to 2% of the pancreas that makes hormones is the endocrine pancreas and its main function is to secrete insulin. Insulin is a hormone we need to keep our blood sugars normal. When the endocrine pancreas isn’t working properly and unable to release the amount (of insulin]) our body needs, we can become hyperglycemic or hypoglycemic — both of which could cause problems if someone has the virus.”
Hyperglycemia occurs when a person’s blood sugar is too high. Long-term side effects include heart disease, nerve and kidney damage. Hypoglycemia is when blood sugar is too low and can immediate consequences such as cause blurred vision, seizures and loss of consciousness.
What will a COVID-19 infection do to my reproductive organs?
“We don’t know if there are any long-term effects to the ovaries. But we do have a little bit of evidence that there might be testicular dysfunction in male COVID-19 patients because there are ACE2 receptors on the testes.”
Whether that lasts longer than the infection itself remains to be seen, Cavaghan said. It’s likely there is recovery, but it’s too soon to tell.
What are the adrenal glands and what are they responsible for? Does the coronavirus affect them?
“The adrenals are interesting because most of the time nobody knows about them unless there’s a problem. They are tiny little glands that sit above the kidneys and their main function is to secrete hormones designed to keep our blood pressure up. The also help us respond to stress.”
Under normal circumstances, the adrenal glands make a stress hormone called cortisol, Cavaghan said, and the body knows just how much to release at any given point.
During periods of duress, a person needs from two to three times as much cortisol than usual. But if he or she can’t make that extra, which may happen if infected with the virus, this can lead to low blood pressure and the inability of oxygen to get to the vital organs.
There’s also another COVID-19-related effect on the adrenal glands, Cavaghan added, and it has to do with a hormone regulating potassium. There have been a number of coronavirus patients that have had low potassium levels. Low potassium levels can lead to heart problems such as arryhthmias.
Hypothalamus-pituitary, aka ‘the master gland‘
“Nicknamed ‘the master gland,’ the hypothalamus-pituitary are responsible for sending signals to all other glands of the endocrine system. When those signals are not secreted properly those glands stop producing the hormones they are designed to secrete.”
In terms of a patient with COVID-19? It’s difficult to tell if a disrupted hypothalamus-pituitary is a COVID-specific effect or the result of another illness.
The body’s accelerator and how the coronavirus can lead to inflammation
“The thyroid, also called the accelerator, affects every cell in the body even though it only makes one hormone: the thyroid hormone,” explained Cavaghan.
“There have been cases of thyroiditis since the COVID-19 pandemic started when a person gets inflammation of the thyroid. Because those thyroid cells already have thyroid hormone in them when they get inflamed, the walls (of those organs) break down and more of the hormone is released resulting in hyperthyroidism because of that pre-release of thyroid hormones.”
Cavaghan says the only treatments known to reduce COVID-19 inflammation are steroids. The most effective steroid to date is dexamethasone, according to recent study published in the New England Journal of Medicine, which has shown to reduce the systemic inflammatory response among coronavirus patients.